ORIGINAL ARTICLE Utility of Low Fidelity Manikins for Learning High Quality Chest Compressions Meenakshi Girish 1 & Alka Rawekar 2 & Sujo Jose 3 & Umesh Chaudhari 1 & Girish Nanoti 1 Received: 13 February 2017 /Accepted: 4 September 2017 # Dr. K C Chaudhuri Foundation 2017 Abstract Objectives Primarily, to measure the adequacy of chest com- pression depth after training on low fidelity manikins and secondarily to assess the comparative experience of the learners on high fidelity and low fidelity simulators. Methods An observational cohort study in which seventy-two first year postgraduate students underwent a Basic Life Support (BLS) workshop conducted by AHA accredited BLS trainers and they were then required to perform on a high fidelity manikin to objectively record the quality of their performance. Results There were 34 (47.22%) male and 38 (52.77%) fe- male participants. CPR skills, as judged by checklist of se- quential actions and visual inspection during the BLS training on low fidelity simulators (LFS) were correctly performed by majority (95.89%) participants. However, none of the partic- ipants could achieve the recommended depth for high quality chest compressions. The participants’ perception of degree of realism and their practical experience on both the types of manikins were similar. Conclusions Low fidelity manikins are useful for training CPR in sequential manner but fail to impart quality of chest compressions as per AHA recommendations. Keywords Chest compressions depth . Low simulator manikins . Basic life support training Introduction Correct cardiopulmonary resuscitation (CPR) technique is crucial for successful patient outcome and optimum chest compressions improve the survival [1–4]. Many studies have documented errors of resuscitation due to inadequate com- pression rate and depth; both factors constitute the core tenets of high quality CPR. Preliminary data suggest that excessive compression rate may be associated with a lower rate of return of spontaneous circulation, and excessive compression depth cause an increased risk of non-life threatening injuries [5]. CPR manikins used in our country for Basic Life Support (BLS) training workshops are generally low fi- delity manikins. Incorporating any degree of computer technology raises the manikin fidelity to middle or high level fidelity by virtue of its ability to give immediate feedback and a very realistic patient representation. American Heart Association (AHA) has made important recommendations regarding depth of cardiac compression in its 2015 guidelines update and has stated that compres- sion depth may be difficult to judge without use of feed- back devices [1]. The AHA recommends a depth of atleast 2 in. (50.8 mm) and not more than 2.4 in. (approx. 60.9 mm) as optimum high quality chest compression. Visual inspection of the depth of compression during training by instructors and emphasis on the use of propor- tion of AP diameter of victim’ s chest as a clue to correct depth is the only performance metrics currently being used in the absence of any kind of feedback device. Thus, this research was designed to study the utility of low fidelity manikins for learning high quality chest * Meenakshi Girish meenakshimgirish@gmail.com 1 Department of Pediatrics, NKP Salve Institute of Medical Sciences, Nagpur, Maharashtra, India 2 Department of Physiology, JNMC, DMIMS, Sawangi, Maharashtra, India 3 Nursing Department, NKP Salve Institute of Medical Sciences, Nagpur, Maharashtra, India Indian J Pediatr DOI 10.1007/s12098-017-2473-3